We propose to establish an institutional training program in Pulmonary and Critical Care Medicine (PCCM) at Stanford University for M.D. and M.D./Ph.D. fellows who seek two years of rigorous research training in preparation for careers and leadership in academic medicine. Our program encompasses academic training in pulmonary medicine composed of basic and clirtical research areas and a unique research area in biomedical ethics. The basic research program will focus on proliferative lung diseases (cancer and fibrotic lung disease) lung inflammation and vascular disease; the clinical research program will focus on clinical epidemiology, health services research; and the biomedical ethics research will focus on ethical and social implications of genetic testing and rational decision-making in end-of-life issues. The training program will be directed by Dr. Thomas Raffin, Professor and Chief of PCCM, and Co-Director of the Stanford University Center for Biomedical Ethics and Co-Directed by Dr. Glenn Rosen, Associate Professor of Medicine. Together with Dr. Raffin and Dr. Rosen, ten faculty mentors will form the core of the program. Our goal for this first five-year period of funding is to train a total of ten trainees (2/year) from around the country, carefully matched to the outstanding faculty mentors, superb resources, and highest standards of our program. During each training period trainees will be required to complete an independent research project, attend courses and a seminar series dedicated to ethical conduct in research, participate in a quarterly T32 seminar series and other seminars and conferences, present original results at internal and at national meetings, and prepare a manuscript for publication in the peer-reviewed literature. Trainees will also be encouraged to apply for independent funding in the second year of the training period to enable a third year of dedicated research. Trainees in the PCCM fellowship will be selected for the training grant by consensus of the program director and training faculty on the basis of their commitment to research and to a career in academic medicine. An emphasis will be placed on recruiting men and women into the PCCM fellowship from diverse ethnic backgrounds with interest in careers and the skills to be competitive in academic medicine. While each trainee will specialize in a single area, extensive cross-fertilization of ideas is expected given the integrated nature of the overall program, close interactions among participants, and the impact the program will have at both an institutional and national level.